title: Comparison of acetabular fracture reduction quality by the ilioinguinal or the anterior intrapelvic (modified Rives-Stoppa) surgical approaches.
abstract: OBJECTIVE
  To compare the reduction quality, surgery time, and early postoperative complications between the 2 following surgical approaches: the ilioinguinal and the anterior intrapelvic (AIP or modified Rives-Stoppa).
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Comparison of 122 patients operated in our center between 1996 and 2003 with the ilioinguinal approach and 103 cases operated between 2004 and 2011 with the AIP approach.
  
  
  METHODS
  Level 1 trauma center, acetabular fracture surgery referral center.
  
  
  METHODS
  The patients' demographics, fracture type, fracture reduction quality, surgery time, and postoperative complications were compared.
  
  
  RESULTS
  Anatomic reduction was achieved in 84 patients (68.9%) treated by the ilioinguinal approach and in 85 patients (82.5%) treated by the AIP approach (P = 0.018). In both the columns, acetabular fracture type anatomic reduction was achieved in 54.2% of the ilioinguinal group and 79.4% of the AIP group (P = 0.018). In the ilioinguinal group, surgery time decreased as the number of surgeries increased (P = 0.021), whereas a similar trend was not found in the AIP group. Fracture type distribution and complication rates were similar for both the groups.
  
  
  CONCLUSIONS
  The AIP approach is a safe alternative that offers better exposure and possibly improved reduction quality of acetabular fractures compared with the ilioinguinal approach. We believe that the major advantage of the AIP approach is that it enables reduction of the posterior column and the quadrilateral plate from the contralateral side and enables application of a buttress plate below the pelvic brim.
  
  
  METHODS
  Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: *Department of Orthopaedic Surgery, Chaim Sheba Medical Center, Tel-Hashomer, Israel; †Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Departments of ‡Imaging and §Anesthesiology, Chaim Sheba Medical Center, Tel-Hashomer, Israel; and ‖Talpiot Medical Leadership Program, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
authors.forename: Nachshon
authors.initials: N
authors.lastname: Shazar
authors.forename: Iris
authors.initials: I
authors.lastname: Eshed
authors.forename: Nissim
authors.initials: N
authors.lastname: Ackshota
authors.forename: Oded
authors.initials: O
authors.lastname: Hershkovich
authors.forename: Alexander
authors.initials: A
authors.lastname: Khazanov
authors.forename: Amir
authors.initials: A
authors.lastname: Herman
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D000328:Adult; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D050723:Fractures, Bone / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010388:Pelvis / Q000601:surgery; D011859:Radiography; D012189:Retrospective Studies